Objective To investigate the influence of abaI expression on acinetobacter baumannii biofilm formation.Methods Acinetobacter baumannii strain S isolated from bums patients was collected for the study,while the standard strain ATCC19606 was served as the control.At 6,24 and 48 hours,the gene expressions of abaI,pgaA,pgaB and pgaC were detected by real-time fluorescent quantitative PT-PCR,secretion of N-acyl-homoserine lactones (AHLs) by biological sensor and biofilm formation by MTT method.Results (1) Gene expressions of abaI,pgaA,pgaB and pgaC at 6 hours were 8.63 ±5.93,1.98 ± 1.93,1.01 ± 1.32 and 2.67 ± 3.46 respectively,which showed a quick increase at 24 hours (22.81 ± 17.60,5.13 ± 4.32,5.66 ± 3.97,11.97 ± 7.75 respectively),followed by a rapid decline in 48 hours (3.43 ± 0.88,1.30 ± 0.24,3.01 ± 3.00,3.02 ± 3.29 respectively).Gene expressions of pgaB and pgaC at 6 hours and that of pgaA and pgaC at 48 hours revealed statistically significant differences from those at 24 hours (P ＜ 0.05).(2) AHLs showed a level of 18.49 ± 11.03 at 6 hours,reached a peak of 52.23 ± 15.95 at 24 hours,then descended to 5.53 ± 0.94 at 48 hours.AHLs level at 24 hours showed statistically significant difference from that at 6 hours and 48 hours (P ＜ 0.05).(3)Biofilm formation at 24 hours and 48 hours was 2.83 ±0.44 and 2.71 ±0.15 respectively,far higher than that at 6 hours (0.49 ± 0.11,P ＜ 0.05).(4) In the correlation analysis among AHLs,biofilm formation and gene abaI,pgaA,pgaB and pgaC expressions,significant positive correlation was found between abaI and pgaA and between AHLs and pgaC expression (P ＜ 0.05).Conclusion Acinetobacter baumannii may regulate gene expressions of pgaA and pgaC responsible for biofilm formation to adjust to the external environment by means of changing abaI gene expression and AHLs secretion.

Objective By analyzing the clinical and pathological characteristics of small intestinal neoplasms of patients presenting at our hospital,this study was to improve our cognition of this disease and the prognosis.Methods We collected and reviewed the medical records of 121 patients suffering from small intestinal neoplasms,who underwent surgery at Ruijin hospital from January 2003 to June 2009.Diagnosis was confirmed by pathological examination,and patients were followed-up.Results Intestinal hemorrhage,anemia and abdominal pain were the three main symptoms for all patients.CT,and gastrointestinal endoscopy were valuable for the diagnosis of small intestine neoplasms.Compared with open surgery,laparoscopic procedures can shorten the operation time and the postoperative length of hospital stay.Conclusions Surgical procedure is the key treatment for patients with small intestinal neoplasms.Long term follow-up plays important role in the detection of other synchronous or metachronous gastrointestinal tumors and improves the prognosis.

Objective To investigate the expression levels of interferon-?-inducible protein 30 genes in CD4~(+) T cells of systemic lupus erythematosus(SLE) patients and to evaluate the relations between the gene expression levels and the disease activities.Methods The clinical data of 23 SLE patients and 10 normal controls were collected.Peripheral blood was drawn and CD4~(+)T cells were separated by using immunomagnetic cell sorting system(MACS).Total RNA was extracted and reversely transcribed into cDNA.Screening and identification of IP-30 in LongSAGE Tags from a SLE patient was done by generation of longer cDNA fragments from serial analysis of gene expression(SAGE) tags for gene identification.Results IP30 expression levels of the total SLE patients were significantly higher than those of normal controls(P

OBJECTIVETo study which classification model was most suitable for establishing a multi-tumor markers lung cancer prediction model, through established logistic regression model, decision trees model and artificial neural network model.

METHODSRIA analysis, ELISA, spectrophotometry, high-performance liquid chromatography (HPLC) and atomic absorption spectrometry were used to measure the serum CEA, CA125, gastrin, NSE, beta2-MG, Sil-6 receptors, sialic acid, nitric oxide, Cu, Zn, Ca and the pseudo-urine nucleoside of urine samples in lung cancer patients, benign lung disease patients and healthy controls. The lung cancer diagnosis models were established by logistic regression analysis, decision tree analysis and artificial neural network training.

RESULTSThe diagnosis sensitivities of the logistic regression analysis, decision tree analysis and artificial neural network model with 12 tumor markers in lung cancer were 94.00%, 100.00% and 100.00%; the specificity were 100.00%, 98.89% and 100.00%; the total accurate 94.29%, 95.00% and 90.00%, respectively.

CONCLUSIONThe results of three classification models with 12 tumor markers in diagnosis of lung cancer are ideal. Especially the C5.0 decision tree model and the artificial neural network model are more suitable for the prediction and diagnosis of the lung cancer.

Aged ; Biomarkers, Tumor ; analysis ; Decision Trees ; Female ; Humans ; Logistic Models ; Lung Neoplasms ; diagnosis ; Male ; Middle Aged ; Neural Networks (Computer)

Objective To explore the change of dietary intake and nutritional status before and after hematopoietic stem cell transplantation (HSCT) in pediatric patients to assess the importance of nutritional interventions.Methods In this observational cohort study,65 children undergoing HSCT between January 2012 and November 2012 in the Department of Hematology and Oncology,Shanghai Children's Medical Center were enrolled.The data collected before preconditioning were considered as the baseline data.We also collected data twice a week between preconditioning and 30 days after HSCT,and once a week from 30 days to 100 days after HSCT.Dietary analysis and urea nitrogen analysis were conducted in parallel.Results The baseline level of energy intake was (5 844.9 ±2 490.4) kJ/d,protein intake was (56.4 ±28.6) g/d,fat intake was (49.7 ±38.9) g/d,and carbohydrate intake was (190.9 ± 91.1) g/d.With the hematopoietic reconstruction,the oral nutrients intake significantly decreased compared with the baseline levels (all P =0.000).During the recovery period after HSCT,the energy intake showed no significant difference when compared with the baseline level in the 6th postoperative week,protein in the 13th week,carbohydrate in the 4th week,and fat in the 6th week.The urine nitrogen was (3.9 ± 2.4) g/d before HSCT,which increased to (16.7 ± 11.0) g/d after preconditioning (P=0.000).In the 1st postoperative week,the weight (P =0.000),triceps skin fold thickness (P =0.003),mid-upper arm circumference (P =0.000),serum albumin (P =0.000) and prealbumin (P =0.000) of the patients all significantly decreased compared with the baseline levels.In the 9th postoperative week,the fat-free body weight percentage (P =0.010),muscle percentage (P =0.001) and protein percentage (P =0.000) were significantly lower than the baseline levels,while the body fat percentage was higher than the baseline level (P =0.002).Conclusions Children undergoing HSCT exhibit a marked reduction in nutrient intakes at the early stage of HSCT,which may gradually return normal during the recovery period.This process may be slow,especially for the protein,and therefore may affect the serum protein level in these pediatric patients.Thus,more careful nutrition guidance is necessary during HSCT for pediatric patients,emphasizing oral nutrients intakes,and high protein dietary or formula may be helpful.

Objective To explore the anatomical characteristic of the third palmar interosseous mus- cle as well its dominate nerve,and to investigate the anatomical basis of difficult recovery of digitus minimus adduction.Methods Twenty aduh fresh hands without deformity and trauma were obtained.Dissect and observe the third palmar interosseous muscle and its dominate nerve and adjacent structure under surgical mi- croseope,measure the size of the third pahnar interosseous muscle and its dominate nerve,the data were pro- cessed by stastistics method.Results Among palmar interosseous muscles and its dominate nerves,the third palmar interosseous muscle and its dominate nerve is the smallest.There are conspicuous tendon bundle on the surface of the third palmar interosseous muscle partly,which have a potential compression on the third palmar interosseous muscle dominting nerve.Conclusion The third palmar interosseous muscle is the smal- lest among palmar interusseous muscles and it is the only digitus minimus adduction muscle.The sominating nerve of the third palmar interosseous muscle is small anti the tendon bundle of the third palmar interosseous muscle have a potential compression.All these can cast light on diffcult recovery of digitus minimus adduction.

Child ; Diagnostic Errors ; Hemorrhagic Fever with Renal Syndrome ; diagnosis ; Humans

Background Congenital fibrosis of extraocular muscles (CFEOM) affects patient' s appearance and quality of life,and no effective treatment for this disease is available.Imaging study is helpful for exploring the pathogenesis of CFEOM.Objective This study was to describe the characteristics of CFEOM associated with limb movement disorder using magnetic resonance imaging (MRI).Methods A family with CFEOM associated with limb movement disorder was investigated in Renmin Hospital of Wuhan University.Disease history was collected and the pedigree was investigated.Ophthalmologic examinations,including corrected visual acuity,refractive error,slitlamp examination,ophthalmoscopic examination,force of levator palpebrae superioris,ocular movement,eye position,forced duction test,and bell phenomenon examination,were performed.Ocular orbital and cranial MRI was performed in 4 CFEOM patients and 10 normal subjects to compare the structures of the extraocular muscles,motor nerve and cranium.Oral informed consent was obtained from each patient prior to any medical examination.Results A total of 1 1 members from 3 generations were investigated in this study,presenting with 4 cases of disease.The mode of inheritance of this family complied with the Mendelian autosomal dominant inheritance law.Clinical signs included disturbance of eye movement,deviation of eye position,ptosis,lack of Bell sign and positive reaction of passive pull test.In addition,unstable gait,improper body limb alignment,dysphasia and mental retardation were ohserved in 1 patient,which coincided with the diagnostic criteria of type 3 CFEOM.MRI results demonstrated that the levator palpebrae superioris,superior rectus and superior oblique muscle were clearly thinner,and the medial rectus,lateral rectus,inferior rectus muscle were thinning in the patients,showing significant differences in comparison with the normal controls(P＜O.05).The oculomotor and abducens nerves became thinner and even absent in the patients.Cranial MRI showed that Ⅲ-3 in the pedigree with callosum was shorter than that of the normal controls,suggesting that patient suffered from corpus callosum hypoplasia.Meanwhile,cranial MRI indicated the presence of cerebellar hypoplasia and the expansion of the fourth ventricle.Conclusions MRI demonstrates consistent abnormalities of the oculomotor nerves and abducens nerves in the affected individuals in this CFEOM 3 family,and some affected members exhibit two types of central nervous system abnormalities-corpus callosum and cerebellar hypoplasia.These findings suggest that CFEOM 3 is primarily a neuronal disease.

OBJECTIVETo evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy combined with limited open repair of medial collateral ligament (MCL) for the treatment of multiple ligament injuries of knee joints.

METHODSFrom March 2006 and June 2012,the data of 14 patients (14 knees) with multiple injuries of ACL, PCL, and MCL were collected. There were 8 males and 6 females with an average age of (31.8 +/- 8.1) years old (ranged, 20 to 49 years old). All the patients were performed with X-ray and MRI examination, and the results showed that 10 patients had combined with injuries of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and medial collateral ligament (MCL); 4 patients had ALC,PCL and posterolateral corner (PLC) injuries. Four patients had medial meniscus injuries and 2 patients had lateral meniscus injuries. The MCL,PLC and meniscus injuries were treated with operation on the first stage, and functional exercises were performed 3 weeks after fixation. The reconstruction operation of ACL and (or) PCL was performed at the second stage under arthroscopy 3 to 6 months later when the movement range of knee joint recovered to the normal level with obvious relaxation.

RESULTSAll incisions healed by primary intention. All the patients were followed up with a mean duration of 48.9 months (ranged, 24 to 80 months). The Lysholm score was improved from preoperative 19.6 +/- 0.9 to the latest follow-up 87.1 +/- 2.8 (t=12.3, P<0.01). The International Knee Documentation Committee (IKDC) rating: 9 cases nearly recovered to normal, 5 cases were abnormal.

CONCLUSIONFor multiple ligament injuries in the knee, staged repair and reconstruction can effectively restore knee joint stability and function.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Female ; Follow-Up Studies ; Humans ; Knee Injuries ; physiopathology ; surgery ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures ; Treatment Outcome ; Young Adult

Objective To explore the changes of hydrogen sulfide(H2S) levels in plasma of newborn infants with pulmonary hypertension(PH) and its relationship with pulmonary hypertension,and provide scientific evidence for the decision of treating neonatal PH.Methods Sixteen children with PH and 16 children without PH in ICU from Mar.2005 to Mar.2006 were selected.Ultrasonic cardiogram(UCG) examination was performed for eachpatients.Pulmonary artery pressure(PAP) was measured.The plasma concentrations of H2S,cysteine and PAP of each patient were measured.Results PAP was 4.27-9.73 kPa[(6.49?1.79) kPa] in neonatal PH group,and PAP in control group was normal.The plasma levels of cysteine and H2S in neonatal PH group significantly increased compared with those of control group [(11.94?6.65) ?mol/L vs(6.43?2.08) ?mol/L,t=2.630 P=0.016;(26.99?1.33) ?mol/L vs(24.92?1.36) ?mol/L,t=4.373 P=0].Conclusions Endogenous H2S and cysteine were up-regulated during the development of neonatal PH;it might play an improtant role in the development of PH.H2S possibly depress the PAP by dilating the pulmonary artery to protect the patients with pulmonary hy pertension.